4.6 Article

Different forms of traumatic brain injuries cause different tactile hypersensitivity profiles

Journal

PAIN
Volume 162, Issue 4, Pages 1163-1175

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.pain.0000000000002103

Keywords

Traumatic brain injury; Tactile allodynia; Posttraumatic headache; Persistent sensitization

Funding

  1. Department of Defense [W81XWH-16-1-0211, W81XWH-16-1-0071]
  2. Department of Veterans Affairs Merit award [1I0RX002101]
  3. Department of Veterans Affairs Career Development Award [IK2 RX002010 012020]
  4. Center for the Prevention and Treatment of Visual Loss from the Department of Veterans Affairs Rehabilitation RD Services [C9251-C]
  5. International Headache Academy research award from the American Headache Society
  6. Brockman Foundation
  7. S. Livingston Samuel Mather Trust
  8. G.R. Lincoln Family Foundation
  9. Louis Stokes VA Medical Center
  10. Elizabeth Ring Mather and William Gwinn Mather Fund

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The study characterized tactile sensory profiles of two nonpenetrating models of posttraumatic headache (PTH). The results showed that repetitive daily injury for 3 days induced more severe phenotypes, offering new insights into patterns of injury that may place patients at a greater risk of developing PTH. The research also provided preclinical support for a pathophysiologic role of calcitonin gene-related peptide in PTH.
Chronic complications of traumatic brain injury represent one of the greatest financial burdens and sources of suffering in the society today. A substantial number of these patients suffer from posttraumatic headache (PTH), which is typically associated with tactile allodynia. Unfortunately, this phenomenon has been understudied, in large part because of the lack of well-characterized laboratory animal models. We have addressed this gap in the field by characterizing the tactile sensory profile of 2 nonpenetrating models of PTH. We show that multimodal traumatic brain injury, administered by a jet-flow overpressure chamber that delivers a severe compressive impulse accompanied by a variable shock front and acceleration-deceleration insult, produces long-term tactile hypersensitivity and widespread sensitization. These are phenotypes reminiscent of PTH in patients, in both cephalic and extracephalic regions. By contrast, closed head injury induces only transient cephalic tactile hypersensitivity, with no extracephalic consequences. Both models show a more severe phenotype with repetitive daily injury for 3 days, compared with either 1 or 3 successive injuries in a single day, providing new insight into patterns of injury that may place patients at a greater risk of developing PTH. After recovery from transient cephalic tactile hypersensitivity, mice subjected to closed head injury demonstrate persistent hypersensitivity to established migraine triggers, including calcitonin gene-related peptide and sodium nitroprusside, a nitric oxide donor. Our results offer the field new tools for studying PTH and preclinical support for a pathophysiologic role of calcitonin gene-related peptide in this condition.

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